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NPI Code Detail

MEDICARE: MR. WILLIAM S BEALL JR. PA

MEDICARE:  MR. WILLIAM S BEALL JR. PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant00795TX

General Provider Information

NPI Number : 1245750512
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM S BEALL JR. PA
Provider Business Mailing Address
First Line : 927 E BLANCO RD
Second Line :
City : BOERNE
State : TX
Zip : 78006-1709
Country : US
Telephone Number : 210-421-4614
Fax Number :
Provider Business Practice Location Address
First Line : 230 E TRAVIS ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78205-1702
Country : US
Telephone Number : 210-421-4614
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2017
Last Update Date : 06/27/2017

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Directions to “ MR. WILLIAM S BEALL JR. PA” Practice Location

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